Clinical Assessment: Home and Family Assessment

Kinship and Living Patterns

Alaska Native older adult function in a highly relational context. When feasible, identify the individuals who are living with the older adult and their relationships to the patient. Composition and structure of the family is important to care giving and decision making. The values “Share what you have” and “Take care of others” may be the rationale for sharing the household. The older person’s role to pass on cultural traditions may bring younger family members and friends into the home.

Support and Family Connectedness

Alaska Native older adult come from a collectivist society, thus there is interconnectedness and interdependence. Change in living arrangements would disrupt cultural integrity, and an intervention that would re-create the bond needs to be implemented as soon as possible.

Safety, Comfort, and Convenience of the Home to Older Adult’s Health Status

The Alaska Home Registry report for 1996 to 2000 showed 62% of falls among older Alaska Natives occurred in the home, and in one fifth of the cases, alcohol consumption was determined to be a contributing factor. Polypharmacy, adverse effects of medication, overmedication, and unintentional self-overdose may be contributing factors as well. In terms of family care patterns, gender, and reaction to having home health aides, there is diversity among the cultural groups. For some Alaska Native families, a specific family member may have been identified as the participant in the health care decision-making situations for the older adult Alaska Native.

Decision-Making

Alaska Native older adult may involve family members in the decision-making process. Sometimes a specific family member has taken on the responsibility for the care of the older adult. This person will take an active role in the decision-making and will step into the role of spokesperson for the Alaska Native older adult.